Long-term intracavernosal injection therapy: treatment efficacy and patient satisfaction

Bearelly, Priyanka; Phillips, Elizabeth A.; Pan, S. H.; O’Brien, Kevin; Asher, Kevin P.; Martinez, Daniel R; Munárriz, Ricardo

doi:10.1038/s41443-019-0186-z

Cited by 14 publications

(16 citation statements)

References 19 publications

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“…These complications were as follows: plaque or scar formation (10%), penile pain (2%), bruising (1%), restlessness (1%),tissue damage(1%), and 1% headache 27 . The authors of the same study claimed that 27% of their patients complained of penile shortening while 1/5 of them developed a new curvature of their penises 27 . This is may be due to recurrent trauma due to repeated injections.…”

Section: Discussionmentioning

confidence: 98%

“…The discontinuation rate for ICI pharmacotherapy is relatively high and may range from 30% to 80%. This relatively high dropout rate is attributed to several factors including the development of adverse effects, unacceptance by the patient/partner, physical or psychological discomfort, lack of durability of the effect, patient's anxiety concerning penile injections, and the high the treatment 6,27,28 …”

Section: Discussionmentioning

confidence: 99%

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Intra‐cavernous injection of BOTOX^® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial

et al. 2021

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Background: Erectile dysfunction (ED) is a socioeconomic problem.There are several options for its management including intra-cavernosal injection (ICI).Objective: To compare the safety, efficacy, and durability of ICI of onabotulinum toxin-A (BTX) in different doses (50 and 100 U) against placebo (saline) in the management of vasculogenic ED non-responding to pharmacological therapy (phosphodiesterase type 5 inhibitors or/and ICI of trimix). Materials and Methods:A prospective randomized double-blind placebo-controlled trial was conducted between July 2016 and February 2019. A total of 176 patients were randomly assigned (1:1:1) to one of the treatment sequences: Botox 100 U group (BTX-100; 62 patients), Botox 50 U group (BTX-50; 59 patients), or placebo group (55 patients). All patients were followed up for 6 months.Results: Significant improvement in all parameters, that is, SHIM score & Erection Hardness Score (EHS), Sexual Encounter Profile (SEP), Global Assessment Score (GAS), and Doppler parameters (p < 0.001) was observed in patients of BTX-100 and BTX-50 groups with maximum improvement at 3rd month of treatment. Around 40% of patients were responders and were able to engage in sexual intercourse. Patients in placebo group did not experience significant improvement (p = 0.264). It was noted that at the 2nd week and 3rd months after treatment, there was no statistically significant difference in the improvement of these parameters in BTX-100 and BTX-50 groups (p > 0.05). In the 6th month, there was a statistically significant difference between the aforementioned groups in favor of BTX-100 (p < 0.01). Conclusions:Only one-time ICI of BTX (50 U and 100 U) is effective and safe for the treatment of refractory ED. This agent has a considerable long duration of action, particularly BTX-100U seems to be more durable.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Intra‐cavernous injection of BOTOX^® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial

et al. 2021

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“…Studies comparing intracavernosal injection with oral therapy have reported significant improvements in satisfaction and IIEF scores. Mulhall (17,25). Our patients' IIEF scores decreased significantly postoperatively compared to the preoperative period.…”

Section: Discussionmentioning

confidence: 55%

“…Another study reported penile pain and priapism at a rate of 6.4% (22). Bearelly et al reported that plaque or scar formation was 10%, pain 2%, ecchymosis <1%, irritability <1%, headache <1% and tissue damage <1% (17). That study also reported 1.44-inch shortening in penile length in 27% of patients and penile curvature in 20%.…”

Section: Discussionmentioning

confidence: 89%

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Evaluation of the efficacy and patient satisfaction of the intracavernosal alprostadil in the treatment of erectile dysfunction following robot-assisted radical prostatectomy

Kocatürk¹,

Altay²,

Bedir³

et al. 2021

New J Urol.

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Objective: Erectile dysfunction (ED) following robot-assisted radical prostatectomy (RARP) is an important problem. The purpose of this study was to evaluate the effectiveness of and patient satisfaction with intracavernosal alprostadil used in the treatment of ED. Material and Methods: Patients using intracavernosal alprostadil in the treatment of ED following RARP were assessed retrospectively. Patients’ demographic characteristics, pre- and postoperative International Index of Erectile Function (IIEF) scores, and general satisfaction evaluated using questions 13 and 14 of the IIEF form were all recorded. Complications developing during treatment, dosages used, and reasons for discontinuation were investigated. Results: Thirty-four patients with a mean age of 61.73±5.80 years were included in the study. Preoperative ED was determined in 52.9% (n=18) of patients. The mean IEFF of the patients who used preoperative, postoperative 1st month, postoperative 3 months after tadalafil use and intracavernosal alprostadil was 20.64 ± 3.46, 15.08 ± 2.09, 15.32 ± 2.18, 26.67 ± 2.30, respectively. The mean length of use of intracavernosal alprostadil was 8.20±2.48 months, and full erection was achieved in 70.58% of patients. Hematoma associated with intracavernosal alprostadil use developed in 2.9% of patients, ecchymosis in 8.8%, and pain in 8.8%. In addition, 73.5% of patients continued to take their medication during the follow-up process. Patients’ general satisfaction following alprostadil therapy was statistically significantly high. Conclusion: Intracavernosal alprostadil therapy following RARP represents a good therapeutic option due to its high success in achieving full erection, low complication rates, and high patient satisfaction. Keywords: erectile dysfunction, Alprostadil, robot-assisted radical prostatectomy

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Male Genitourinary Dysfunction as a Consequence of Colorectal Surgery

Mantilla

McNevin

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Male genitourinary function can be severely affected after pelvic surgery-even when performed for benign disease. Sympathetic and parasympathetic nerves instrumental to normally functioning neural pathways can be located in close proximity to left colon and rectal structures.• Many questionnaires are available to measure male genitourinary function. None are perfect and choosing the best tool depends on the outcome being studied. • Radiotherapy and to some degree chemotherapy both can have detrimental effects on male genitourinary function. • Selecting interventions to improve quality of life dependson compassionate questioning and building a rapport with the patient. This ideally should begin before starting treatment. • Sexual function and dysfunction after surgery in LGBTQ patients is often ignored by caregivers and poorly studied. This group of patients can experience unique quality of life problems after pelvic surgery, and awareness is the first step to studying and understanding their needs.

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Long-term intracavernosal injection therapy: treatment efficacy and patient satisfaction

Cited by 14 publications

References 19 publications

Intra‐cavernous injection of BOTOX^® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial

Intra‐cavernous injection of BOTOX^® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial

Evaluation of the efficacy and patient satisfaction of the intracavernosal alprostadil in the treatment of erectile dysfunction following robot-assisted radical prostatectomy

Male Genitourinary Dysfunction as a Consequence of Colorectal Surgery

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Long-term intracavernosal injection therapy: treatment efficacy and patient satisfaction

Cited by 14 publications

References 19 publications

Intra‐cavernous injection of BOTOX® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial

Intra‐cavernous injection of BOTOX® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial

Evaluation of the efficacy and patient satisfaction of the intracavernosal alprostadil in the treatment of erectile dysfunction following robot-assisted radical prostatectomy

Male Genitourinary Dysfunction as a Consequence of Colorectal Surgery

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Intra‐cavernous injection of BOTOX^® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial

Intra‐cavernous injection of BOTOX^® (50 and 100 Units) for treatment of vasculogenic erectile dysfunction: Randomized controlled trial